WO2021111320A1 - Methods for treating behavioral and psychological symptoms in patients with dementia - Google Patents
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- WO2021111320A1 WO2021111320A1 PCT/IB2020/061367 IB2020061367W WO2021111320A1 WO 2021111320 A1 WO2021111320 A1 WO 2021111320A1 IB 2020061367 W IB2020061367 W IB 2020061367W WO 2021111320 A1 WO2021111320 A1 WO 2021111320A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/13—Amines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
- A61K31/27—Esters, e.g. nitroglycerine, selenocyanates of carbamic or thiocarbamic acids, meprobamate, carbachol, neostigmine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/445—Non condensed piperidines, e.g. piperocaine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
Definitions
- the present invention provides a method for treating behavioral and psychological symptoms in patients with dementia comprising administering an effective dose of pure 5-HT, receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist.
- the present invention also relates to a pharmaceutical combination comprising pure 5-HT 6 receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist, in particular for treating behavioral and psychological symptoms in patients with dementia.
- the present invention further provides use of the said compounds in the manufacture of a medicament, and a pharmaceutical composition comprising the said compounds intended for the treatment of disorders described herein.
- AD dementia Alzheimer's disease
- LDD Lewy body dementia
- VD vascular dementia
- PD Parkinson’s disease
- FTD frontotemporal dementia
- BPSD Behavioral and psychological symptoms are one of the common symptoms observed across the forms of dementia which represent a heterogeneous group of non-cognitive symptoms and behaviors.
- BPSD Behavioral and psychological symptoms of dementia
- BPSD neuropsychiatric Inventory
- AD psychosis In addition to occurring in patients with AD, psychosis also occurs in patients with other dementias of a wide variety of etiologies (J Cell Mol Med 2012; 16:995-1012). Among patients with AD psychosis, it is reported that an increased occurrence of severe psychosis is associated with an increased presence of delusions and hallucinations as well as symptoms of agitation/aggression. Currently, no pharmacological treatment is approved for patients with AD psychosis, particularly, patients experiencing severe psychotic symptoms.
- Agitation/aggression is highly prevalent in patients with dementia which involves emotional distress for patients and caregivers, risk of institutionalization, and faster rate of disease state progression. Individual items of agitation/aggression, aberrant motor behavior, aberrant vocalizations, irritability/lability, anxiety, and disinhibition from the NPI may represent agitation/aggression.
- no pharmacological treatment is approved for the treatment of agitation/aggression in patients with dementia.
- Apathy is also commonly observed in dementia and is a primary cause of caregiver distress. Apathy is characterized by lack of motivation, decreased initiative, akinesia, and emotional indifference.
- no pharmacological treatment is approved for the treatment of apathy in patients with dementia. Depression is also common in the dementia population.
- Atypical antipsychotics have been associated with statistically significant acceleration of cognitive deterioration in patients with AD.
- Pimavanserin a 5-HT 2A receptor antagonist which was recently approved for PD psychosis had shown statistically significant effect on Neuropsychiatric Inventory Nursing Home Version (NPI-NH) psychosis scale at week 6, however, no effect was for agitation in AD study ( The lancet neurology, 2018, 17, 213-222 ⁇ , NCT02992132).
- Citalopram (30mg daily dose) for agitation in AD study showed a significant decrease in agitation in 186 patients with AD ( JAMA 2014; 311:682-91). Worsening of cognition and QT interval prolongation were seen in citalopram treatment group.
- WO2015083179 discloses process for large scale production of l-[(2- bromophenyl) sulfonyl] -5 -methoxy-3 - [(4-methyl- 1 -piperazinyl)methyl] - lh-indole dimesylate monohydrate.
- WO2017199071 discloses a combination of pure 5-HT ⁇ receptor (5-HTeR) antagonists and acetylcholinesterase inhibitors for the treatment of cognitive disorders.
- WO2017199072 discloses a combination of pure 5-HT ( R antagonists and NMD A antagonist for the treatment of cognitive disorders.
- W02019008484 discloses the uses of a pure 5-HT 6 R antagonist, specifically 1 - [(2-Bromophenyl) sulfonyl] -5-methoxy-3 - [(4-methyl- 1 -piperazinyl)methyl] - 1 Id- indole or a pharmaceutically acceptable salt thereof.
- this patent application did not disclose the combination of 5-HT ( R antagonists and acetylcholinesterase inhibitors for the treatment of behavioral and psychological symptoms in patients with dementia.
- the 5-HT 6 R antagonists had shown the activity on one of the NPI domain that is apathy (WO2017/194496). There is no information on the potential utility on other important domains of NPI in this said patent WO2017/194496.
- the NPI domains though are clubbed under single scale but the causative biological reasons for each of these symptoms are different. A person skilled in the art would not expect that if a 5-HT 6 R antagonist is active in one domain, that means it will show activity in other domains as well.
- the effect of donepezil is mainly observed in the NPI domain namely apathy ( Int J Geriatr Psychiatry. 2011 Feb;26(2): 150-7). Further, donepezil was evaluated for the treatment of agitation/aggression in patients with Alzheimer’s disease, however, donepezil failed to show significant effect compared to placebo (N Engl J Med. 2007 Oct 4;357(14):1382-92).
- the NMDA receptor antagonist, memantine is expected to work by blocking the glutamate in the brain ( Neurotox Res (2013) 24:358-369) whereas the 5-HT,R antagonists work by increasing the glutamate levels in the brain in addition to other mechanisms including increasing acetylcholine levels (. Expert Opin Investig Drugs. 2015;24(12):1515-28). Thus given these contrasting mechanisms it is not anticipated that the combination of a pure 5-HT,R antagonist and NMDA receptor antagonist would show coherence or positive effects in their pharmacological activity in the domains of BPSD.
- Masupirdine ( 1 - [(2-bromophenyl)sulfonyl] -5-methoxy-3 - [(4-methyl- 1 - piperazinyl)methyl]-lH-indole) is a pure 5-HT 6 R antagonist with high selectivity over closely related serotonin subtypes.
- the instant invention provides pure 5-HT,R antagonist or the pharmaceutically acceptable salt(s) thereof, which treats BPSD in combination with or as an adjunct to acetylcholinesterase inhibitors or NMDA receptor antagonist.
- the present invention is based on the unexpected and surprising finding that the combination of pure 5-HT,R antagonist and the compounds which act as acetylcholinesterase inhibitor such as donepezil or NMDA receptor antagonist, memantine addresses in patients with dementia an array of behavioral and psychological symptoms like agitation/aggression, psychosis (delusions and/or hallucinations), anxiety, apathy and sleep disorders and others.
- the pure 5-HT 6 R antagonist, masupirdine or the pharmaceutically acceptable salt(s) thereof of the instant invention is more effective in combination with donepezil or memantine in the treatment of BPS D.
- the present invention provides a method for the treatment of behavioral and psychological symptoms in patients with dementia, comprising administering an effective dose of a pure 5-HT 6 receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist.
- the present invention provides a method for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, dementia associated with schizophrenia, Parkinson’s disease dementia, Lewy body dementia, vascular dementia, and frontotemporal dementia, comprising administering an effective dose of pure 5-HT, receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia, comprising administering an effective dose of pure 5-HT 6 receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist, wherein the behavioral and psychological symptoms in dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night time behavior, or appetite and eating change.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia, comprising administering an effective dose of pure 5-HT ⁇ receptor antagonist and an acetylcholinesterase inhibitor or NMDA receptor antagonist, wherein the pure 5-HT 6 receptor antagonist is masupirdine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor, wherein the acetylcholinesterase inhibitor is selected from donepezil, rivastigmine, and galantamine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist, memantine or a pharmaceutically acceptable salt thereof.
- the present invention relates to use of a pure 5-HT 6 receptor antagonist and an acetylcholinesterase inhibitor, in the manufacture of a medicament for the treatment of behavioral and psychological symptoms in patients with dementia, wherein the pure 5-HT 6 receptor antagonist is masupirdine or a pharmaceutically acceptable salt thereof.
- the present invention relates to use of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor, in the manufacture of a medicament for the treatment of behavioral and psychological symptoms in patients with dementia, wherein the acetylcholinesterase inhibitor is selected from donepezil, rivastigmine, and galantamine or a pharmaceutically acceptable salt thereof.
- the present invention relates to use of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist, memantine or a pharmaceutically acceptable salt thereof, in the manufacture of a medicament for the treatment of behavioral and psychological symptoms in patients with dementia.
- the present invention relates to a pharmaceutical composition
- a pharmaceutical composition comprising pure 5-HT 6 receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof, and an acetylcholinesterase inhibitor for the treatment of behavioral and psychological symptoms in patients with dementia, wherein the acetylcholinesterase inhibitor is selected from donepezil, rivastigmine, and galantamine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a pharmaceutical composition
- a pharmaceutical composition comprising pure 5-HT ⁇ receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof, and NMDA receptor antagonist, memantine or a pharmaceutically acceptable salt thereof for the treatment of behavioral and psychological symptoms in patients with dementia.
- the present invention relates to a pharmaceutical combination of pure 5-HT 6 receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor for the treatment of behavioral and psychological symptoms in patients with dementia, wherein the acetylcholinesterase inhibitor is selected from donepezil, rivastigmine, and galantamine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a pharmaceutical combination of pure 5-HT 6 receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist, memantine or a pharmaceutically acceptable salt thereof for the treatment of behavioral and psychological symptoms in patients with dementia.
- Figure 1 Effect of combined masupirdine and donepezil on aggression levels compared to masupirdine or donepezil alone.
- Figure 2 Effect of combined masupirdine and memantine on aggression levels compared to masupirdine or memantine alone.
- Figure 3 Effect of combined masupirdine and donepezil on hallucination compared to masupirdine or donepezil alone.
- Figure 4 Effect of combined masupirdine and donepezil on dopamine and norepinephrine levels compared to donepezil in prefrontal cortex of male Wistar rats.
- Figure 5 Effect of combined masupirdine and memantine combination on dopamine and norepinephrine levels compared to memantine in prefrontal cortex of male Wistar rats
- 5-HT 6 receptor antagonist refers to a ligand or drug that shows affinity towards 5-HT, receptor, blocks or inhibits the function/ binding of 5-HT, receptor agonist.
- pure 5-HT ⁇ receptor antagonist refers to a 5-HT ⁇ receptor antagonist which has very high selectivity (>250 fold) over closely related serotonin subtypes like 5-HT IA , 5-HT IB , 5-HT ID , 5-HT 2A , 5-HT 2C , 5-HT 4 , 5-HT SA, and 5-HT 7 .
- Example of pure 5-HT 6 receptor antagonist is (l-[(2-Bromophenyl)sulfonyl]- 5-methoxy-3 - [(4-methyl- 1 -piperazinyl)methyl] - 1 H-indole) .
- the international nonproprietary name (INN) for (l-[(2- Bromophenyl) sulfonyl] -5-methoxy-3 - [(4-methyl- 1 -piperazinyl)methyl] - 1 H- indole) is masupirdine.
- Example of pharmaceutically acceptable salt of above pure 5-HT 6 receptor antagonist, masupirdine is dimesylate monohydrate.
- Masupirdine dimesylate monohydrate is also known as SUVN-502 which has the chemical structure as shown below.
- Masupirdine is commonly administered as masupirdine dimesylate monohydrate.
- the compound, masupirdine dimesylate monohydrate and its preparation were described in US patents US7875605, US9540321 and in article J. Med. Chem. 2017, 60, 5, 1843-1859.
- active ingredient or “active compound(s)” or “compound(s)” as used herein refers to a 5-HT 6 receptor antagonist or an acetylcholinesterase inhibitor or NMD A receptor antagonist.
- the 5-HT, receptor antagonist is (l-[(2- Bromophenyl) sulfonyl] -5-methoxy-3 - [(4-methyl- 1 -piperazinyl)methyl] - 1 H- indole) or a pharmaceutically acceptable salt
- the acetylcholinesterase inhibitor is donepezil, rivastigmine, galantamine or pharmaceutically acceptable salts thereof
- NMDA receptor antagonist is memantine or pharmaceutically acceptable salts thereof.
- acetylcholinesterase inhibitor is a chemical or drug that inhibits acetylcholinesterase enzyme from breaking down acetylcholine, thereby increases levels of the neurotransmitter acetylcholine.
- acetyl cholinesterase inhibitors are; donepezil, rivastigmine, and galantamine.
- the acetylcholinesterase inhibitor is donepezil, rivastigmine, galantamine, or pharmaceutically acceptable salts thereof.
- Donepezil is a drug approved for the treatment of mild, moderate, and severe dementia of AD.
- Donepezil is a reversible inhibitor of the enzyme acetylcholinesterase and sold under trade name Aricept ® as hydrochloride salt.
- Rivastigmine is a drug approved for treatment of mild, moderate and severe dementia of AD. Rivastigmine is a reversible cholinesterase inhibitor and sold under trade name Exelon® and Exelon Patch® as tartrate salt.
- Galantamine is a drug approved for treatment of mild, moderate and severe dementia of AD.
- Galantamine a reversible, competitive acetylcholinesterase inhibitor and sold under trade name Razadyne® as hydrobromide salt.
- NMDA receptor antagonist refers to class of compounds which act on glutamatergic system by inhibiting the NMDA receptor.
- Example of NMDA receptor antagonist is memantine.
- Memantine is a drug approved for treatment of moderate to severe dementia of the AD.
- Memantine is sold under trade name Namenda ® and Namenda XR ® as hydrochloride salt.
- an effective amount or “an effective dose” is defined as an amount of a compound of the present invention that (i) treats the particular disease, condition, or disorder, (ii) eliminates one or more symptoms of the particular disease, condition or disorder and (iii) delays the onset of one or more symptoms of the particular disease, condition or disorder described herein.
- pharmaceutically acceptable salt(s) refers to salts of the active compound and are prepared by reaction with the appropriate organic or inorganic acids or acid derivatives, depending on the particular substituents found on the compounds described herein.
- the pharmaceutically acceptable salts include but are not limited to, dimesylate, dihydrochloride, oxalate, succinate, and tartrate and alike.
- the pharmaceutically acceptable salts are dihydrochlorides and dimesylates. More preferably, the pharmaceutically acceptable salt is dimesylate or hydrochloride.
- patient(s) refers to an animal.
- patient(s) refers to a mammal.
- mammal includes animals such as mice, rats, dogs, rabbits, pigs, monkeys, elephants, camels, horses, and humans. More preferably the term “patient(s)” refers to humans.
- BPSD neuropsychiatric symptoms
- Behavioral and psychological symptoms include domains like agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night time behavior or appetite and eating change. It also refers to any physical or verbal behavior of dementia patients which has the effect of hurting or repelling others, and includes aggressive behaviors such as beating, kicking, biting, and screaming.
- D dementia Alzheimer's disease
- PD dementia dementia associated with schizophrenia
- LSD dementia Lewy body dementia
- FTD frontotemporal dementia
- agitation/aggression refers to “agitation and/or aggression”.
- delusion and/or hallucinations refers to “delusions or hallucinations, or delusions and hallucinations.
- Alzheimer’s disease refers to dementia that causes problems with memory, thinking, and behavior. Alzheimer’s disease can be mild, moderate or severe.
- treatment or “treating” as used herein refers to any treatment of a disease in a mammal, including: (a) slowing or arresting the development of clinical symptoms; and/or (b) causing the regression of clinical symptoms.
- compound for use as used herein embrace any one or more of the following: (1) use of a compound, (2) method of use of a compound, (3) use in the treatment of, (4) the use for the manufacture of pharmaceutical composition/ medicament for treatment/treating or (5) method of treatment/treating/preventing/ reducing/inhibiting comprising administering an effective amount of the active compound to a patient in need thereof.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the dementia is selected from Alzheimer’s disease dementia, dementia associated with schizophrenia, Parkinson’s disease dementia, Lewy body dementia, vascular dementia, and frontotemporal dementia.
- the behavioral and psychological symptoms in patient with dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia associated with schizophrenia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Parkinson’s disease dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Lewy body dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with vascular dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with frontotemporal dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and an acetylcholinesterase inhibitor.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with dementia associated with schizophrenia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Parkinson’s disease dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with Lewy body dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with vascular dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the present invention relates to a method for the treatment of behavioral and psychological symptoms in patients with frontotemporal dementia, comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist.
- the behavioral and psychological symptoms in patient with Alzheimer’s disease dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the behavioral and psychological symptoms in patient with dementia associated with schizophrenia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the behavioral and psychological symptoms in patient with Parkinson’s disease dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, , sleep and night-time behavior change, and appetite and eating change.
- the behavioral and psychological symptoms in patient with Lewy body dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the behavioral and psychological symptoms in patient with vascular dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the behavioral and psychological symptoms in patient with frontotemporal dementia are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria,, irritability, depression/dysphoria, apathy, disinhibition, delusions, hallucinations, sleep and night-time behavior change, and appetite and eating change.
- the acetylcholinesterase inhibitor is selected from donepezil, rivastigmine, and galantamine or a pharmaceutically acceptable salt thereof.
- the NMDA receptor antagonist is memantine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a method for the treatment of the behavioral and psychological symptom in patient with dementia comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and donepezil or a pharmaceutically acceptable salt thereof.
- the present invention relates to a method for the treatment of the behavioral and psychological symptom in patient with dementia comprising administering an effective dose of masupirdine or a pharmaceutically acceptable salt thereof and memantine or a pharmaceutically acceptable salt thereof.
- the pharmaceutically acceptable salt of masupirdine is selected from mesylate, hydrochloride, oxalate, succinate, and tartrate salts.
- the pharmaceutically acceptable salt of masupirdine is dimesylate monohydrate.
- the pharmaceutically acceptable salt of donepezil is donepezil hydrochloride.
- the pharmaceutically acceptable salt of memantine is memantine hydrochloride.
- the behavioral and psychological symptom in patient with dementia is agitation/aggression.
- the behavioral and psychological symptom in patient with dementia is delusions and/or hallucinations.
- the behavioral and psychological symptom in patient with dementia is delusions. In preferred embodiment, the behavioral and psychological symptom in patient with dementia is hallucinations.
- the behavioral and psychological symptom in patient with dementia is sleep and night-time behavior change. In preferred embodiment, the behavioral and psychological symptom in patient with dementia is appetite and eating change.
- the behavioral and psychological symptom in patient with dementia is aberrant motor behavior.
- the behavioral and psychological symptom in patient with dementia is aberrant vocalizations ⁇
- the behavioral and psychological symptom in patient with dementia is irritability.
- the behavioral and psychological symptom in patient with dementia is apathy. In preferred embodiment, the behavioral and psychological symptom in patient with dementia is depression/dysphoria.
- the behavioral and psychological symptom in patient with dementia is disinhibition.
- the behavioral and psychological symptom in patient with dementia is elation/euphoria.
- the behavioral and psychological symptom in patient with dementia is anxiety.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is agitation/aggression. In preferred embodiment, the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is delusions and/or hallucinations
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is delusions. In preferred embodiment, the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is hallucinations.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is sleep and night-time behavior change.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is appetite and eating change.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is aberrant motor behavior.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is aberrant vocalizations. In preferred embodiment, the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is irritability.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is apathy.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is depression/dysphoria.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is disinhibition.
- the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is elation/euphoria. In preferred embodiment, the behavioral and psychological symptom in patient with Alzheimer’s disease dementia is anxiety.
- the present invention relates to a method for the treatment of agitation/aggression in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of delusions and/or hallucinations in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of delusions in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of hallucinations in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of sleep and night-time behavior change in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of appetite and eating change in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of aberrant motor behavior in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of aberrant vocalizations in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of anxiety in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of irritability in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of apathy in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of depression/dysphoria in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of disinhibition in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of elation/euphoria in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to a method for the treatment of anxiety in patients with Alzheimer’s disease dementia, comprising administering an effective dose of masupirdine dimesylate monohydrate and donepezil hydrochloride or memantine hydrochloride.
- the present invention relates to use of pure 5-HT 6 receptor antagonist, masupirdine or a pharmaceutically acceptable salt and an acetylcholinesterase inhibitor as described above in the manufacture of a medicament for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, dementia associated with schizophrenia, Parkinson’s disease dementia, Lewy body dementia, vascular dementia, and frontotemporal dementia, wherein the behavioral and psychological symptoms are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the present invention relates to use of pure 5-HT ⁇ receptor antagonist, masupirdine or a pharmaceutically acceptable salt and NMDA receptor antagonist as described above in the manufacture of a medicament for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, dementia associated with schizophrenia, Parkinson’s disease dementia, Lewy body dementia, vascular dementia, and frontotemporal dementia, wherein the behavioral and psychological symptoms are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, delusions, hallucinations, sleep and night-time behavior change, and appetite and eating change.
- the pure 5-HT 6 receptor antagonist and acetylcholinesterase inhibitor or NMDA receptor antagonist as described above can be administered to the patient simultaneously, separately, or sequentially.
- the pure 5-HT 6 receptor antagonist as described above can be administered to the patient in combination with or as an adjunct to acetylcholinesterase inhibitor or NMDA receptor antagonist.
- the present invention relates to a pharmaceutical combination of pure 5-HT 6 receptor antagonist and an acetylcholinesterase inhibitor; wherein the pure 5-HT(, receptor antagonist is masupirdine or a pharmaceutically acceptable salt thereof and acetylcholinesterase inhibitor is donepezil, rivastigmine, and galantamine, or a pharmaceutically acceptable salt thereof.
- the present invention relates to a pharmaceutical combination of pure 5-HTV, receptor antagonist and NMDA receptor antagonist; wherein the pure 5-HT(, receptor antagonist is masupirdine or a pharmaceutically acceptable salt thereof and NMDA receptor antagonist is memantine or a pharmaceutically acceptable salt thereof.
- the present invention relates to a pharmaceutical combination comprising masupirdine dimesylate monohydrate and donepezil hydrochloride.
- the present invention relates to a pharmaceutical combination comprising masupirdine dimesylate monohydrate and memantine hydrochloride.
- the present invention relates to the said pharmaceutical combination for the treatment of behavioral and psychological symptoms in patients with Alzheimer’s disease dementia, dementia associated with schizophrenia, Parkinson’s disease dementia, Lewy body dementia, vascular dementia, and frontotemporal dementia, wherein the behavioral and psychological symptoms are selected from agitation/aggression, delusions and/or hallucinations, aberrant motor behavior, aberrant vocalizations, anxiety, elation/euphoria, irritability, depression/dysphoria, apathy, disinhibition, sleep and night-time behavior change, and appetite and eating change.
- the present invention relates to the said pharmaceutical combination for the treatment of agitation/aggression in patients with Alzheimer’s disease dementia.
- the present invention relates to the said pharmaceutical combination for the treatment of delusions and/or hallucinations in patients with Alzheimer’s disease dementia.
- the active ingredients of the present invention can be administered in all possible routes of administration.
- the active ingredients of the present invention may be administered by oral, nasal, local, or parenteral routes.
- the active ingredients of the present invention can be administered by the same or different route of administration.
- the S-HTe receptor antagonist of the instant invention can be administered orally and the acetylcholinesterase inhibitor or NMDA receptor antagonist can be administered transdermally.
- the active ingredients of the present invention are normally administered by formulating the active ingredients into a pharmaceutical composition in accordance with standard pharmaceutical practice.
- compositions of the present invention may be formulated in a conventional manner using one or more pharmaceutically acceptable excipients.
- the pharmaceutically acceptable excipients are diluents, disintegrants, binders, lubricants, glidants, polymers, coating agents, solvents, co-solvents, preservatives, wetting agents, thickening agents, antifoaming agents, sweetening agents, flavouring agents, antioxidants, colorants, solubilizers, plasticizer, dispersing agents and the like.
- Excipients are selected from microcrystalline cellulose, mannitol, lactose, pre gelatinized starch, sodium starch glycolate, corn starch or derivatives thereof, povidone, crospovidone, calcium stearate, glyceryl monostearate, glyceryl palmitostearate, talc, colloidal silicon dioxide, magnesium stearate, sodium lauryl sulfate, sodium stearyl fumarate, zinc stearate, stearic acid or hydrogenated vegetable oil, gum arabica, magnesia, glucose, fats, waxes, natural or hardened oils, water, physiological sodium chloride solution or alcohols, for example, ethanol, propanol or glycerol, sugar solutions, such as glucose solutions or mannitol solutions and the like or a mixture of the various excipients.
- the active ingredients of the invention may be formulated in the form of pills, tablets, coated tablets, capsules, powder, granules, pellets, patches, implants, films, semi-solids, liquids, gels, aerosols, emulsions, elixirs and the like.
- Such pharmaceutical compositions and processes for preparing same are well known in the art.
- the pharmaceutical composition of the present invention contains 1 to 90 %, 5 to 75 % and 10 to 60 % by weight of the active compounds of the instant invention or pharmaceutically acceptable salt thereof.
- the amount of the active compounds or its pharmaceutically acceptable salt in the pharmaceutical composition(s) can range from about 1 mg to about 500 mg or from about 5 mg to about 400 mg or from about 5 mg to about 250 mg or from about 7 mg to about 150 mg or in any range falling within the broader range of 1 mg to 500 mg.
- the pharmaceutical composition of the present invention can be conventional formulations such as immediate release formulations, modified release formulations such as sustained release formulations, delayed release formulations, and extended release formulations or new delivery systems such as orally disintegrating formulations and transdermal patches.
- the dose of the active compounds can vary depending on factors such as age and weight of patient, nature, route of administration and severity of the disease to be treated and such other factors.
- the 5-HT 6 receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof can be administered with acetylcholinesterase inhibitor or NMDA receptor antagonist at a daily dose of 25 mg to 125 mg; such as 25, 30, 50, 75, 100, or 125, preferably at a daily dose of 25, 30, 50, 75, 100 or 125 mg and most preferably at a daily dose of 10, 25, 50, 75, 100 or
- the acetylcholinesterase inhibitor can be co administered with 5-HT 6 receptor antagonist at a daily dose of 5 mg to 30 mg; 5, 6, 8, 9.5, 10, 12, 13, 13.3, 15, 16, 23, 24, 25 or 30 mg, preferably at a daily dose of 5, 6, 8, 9.5, 10, 12, 13, 13.3, 16, 23, 24, or 25 mg and most preferably at a daily dose of 5,
- the acetylcholinesterase inhibitor, donepezil can be co administered with 5-HT 6 receptor antagonist at a daily dose of 5 mg to 30 mg; such as 5, 10, 15, 23, 25 or 30 mg, preferably at a daily dose of 5, 10, 23 or 25 mg and most preferably at a daily dose of 5, 10 or 23 mg.
- the NMDA receptor antagonist, memantine can be co administered with 5-HT 6 receptor antagonist at a daily dose of 5 mg to 40 mg; such as 5, 7, 10, 14, 20, 21, 28 or 40 mg, preferably at a daily dose of 5, 7, 10, 14, 21 or 28 mg.
- the treatment comprises administering to the patient 25 mg to 125 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 50 mg to 100 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 25 mg to 50 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 75 mg to 100 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day. In yet another aspect, the treatment comprises administering to the patient 25 mg to 75 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 75 mg to 125 mg of masupirdine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 5 mg to 25 mg of donepezil or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 5 mg, 10 mg or 23 mg of donepezil or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 5 mg to 30 mg of memantine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 5 mg to 25 mg of memantine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering to the patient 5 mg, 7 mg, 14 mg, 10 mg, 21 mg, 25 mg, 28 mg or 30 mg of memantine or a pharmaceutically acceptable salt thereof, per day.
- the treatment comprises administering the 5-HT ⁇ receptor antagonist, masupirdine or a pharmaceutically acceptable salt thereof and acetylcholinesterase inhibitor or NMDA receptor antagonist, to the patient one to three times per day, one to three times per week or one to three times per month.
- the treatment comprises administering the compound to a patient once a day, twice a day or thrice a day. More preferably, the treatment comprises administering the compound to a patient once a day or twice a day.
- 5-HT 1D 5 -Hydroxy tryptamine ID receptor 5-HT 2A 5 -Hydroxy tryptamine 2 A receptor 5-HT 2C 5 -Hydroxy tryptamine 2C receptor 5-HT 4 5 -Hydroxy tryptamine 4 receptor 5-HTSA 5 -Hydroxy tryptamine 5 A receptor 5-HT 6 5 -Hydroxy tryptamine 6 receptor
- a stable CHO cell line expressing recombinant human 5-HT 6 receptor and pCRE- Luc reporter system was used for cell-based assay.
- the assay offers a non radioactive based approach to determine binding of a compound to GPCRs.
- the level of intracellular cAMP which is modulated by activation or inhibition of the receptor is measured.
- the recombinant cells harbor luciferase reporter gene under the control of cAMP response element.
- the above cells were grown in 96 well clear bottom white plates in Hams F12 medium containing 10% fetal bovine serum (FBS). Prior to the addition of compound or standard agonist, cells were serum starved overnight.
- FBS fetal bovine serum
- Increasing concentrations of test compound were added along with 10 mM of serotonin in OptiMEM medium to the cells. The incubation was continued at 37°C in CO2 incubator for 4 h. Medium was removed and cells were washed with phosphate buffered saline. The cells were lysed and luciferase activity was measured in a Lumino meter. Luminescence was plotted against the compound concentrations using GraphPad Prism software. EC50 value of the compound was defined as the concentration required in reducing the luciferase activity by 50%. The K b value was calculated by feeding the concentration of agonist used in the assay and its EC50 value in the same software.
- Masupirdine exhibits antagonistic activity in CRE-Luc based reporter gene assay on the human recombinant 5-HT 6 receptor with no detectable agonist activity.
- the K b value of masupirdine is 4.2 ⁇ 0.9 nM.
- Receptor source Human recombinant 5-HT ⁇ receptor expressed in HeLa cells
- Radioligand [ 3 H]-LSD (60-80 Ci/mmol)
- Non-Specific Ligand 5 mM Serotonin (5-HT)
- Masupirdine selectively binds to 5-HT 6 receptor when tested by the in-vitro radioligand binding technique on the human recombinant 5-HT 6 receptor.
- the IQ value of masupirdine is 2.04 nM.
- Receptor source Recombinant mammalian cells
- Non-Specific Ligand 0.1 mM 1-Naphthylpiperazine (1-NP)
- Masupirdine binds weakly to 5-HT 2A receptors when tested by the in-vitro radioligand binding technique on the human recombinant 5-HT 2A receptor.
- the IQ value of masupirdine is 2514 ⁇ 377 nM.
- Masupirdine was also evaluated for its 5-HT, receptor selectivity over closely related serotonin subtypes like 5-HTIA, 5-HTI B , 5-HTI D , 5-HT 2A , 5-HT2 C , 5-HT 4 , 5-HT S A , and 5-HT 7 in commercial panel at Novascreen.
- Masupirdine has shown selectivity of more than 250-fold, over these receptor subtypes.
- mice Male Swiss albino mice of weight range 30-40 g (Resident) and 15-25g (Intruder) were used. Resident mice were habituated individually with an ovariectomized female mouse in each cage for at least 2 weeks and intruders were habituated socially for at least 5 days. b-Estradiol at a dose of 0.2 mg/kg, s.c. was administered to ovariectomized female mice during habituation. After habituation for 3 weeks, the intruder was exposed to resident mice for a period of 10 min in the home cage of resident animal and duration of attack was recorded for two days (day 1 & 2).
- mice ovariectomized female mice were removed from resident cage, resident animals were randomized based on their duration of attack. On day 4 (from initial exposure), resident animals were administered respective treatments. Masupirdine (0.30 mg/kg, p.o.) was administered 60 min prior to the trial and donepezil (0.30 mg/kg, i.p.) or memantine (0.30 mg/kg, i.p. ) was administered 30 min prior to the trial. After post dose interval resident mice were exposed to same intruder for 10 min and duration of attack was recorded. Data were analyzed using GraphPad Prism software. Observations:
- Vehicle treated group showed equal duration of attack when compared with its basal.
- Group treated with masupirdine (0.30 mg/kg, p.o.) alone showed equal duration of attack when compared with its basal.
- Group treated with donepezil (0.30 mg/kg, i.p.) or memantine (0.30 mg/kg, i.p.) alone showed decrease in duration of attack when compared with its basal; however it was not statistically significant.
- Group treated with the combination of masupirdine and donepezil or memantine showed significant decrease in duration of attack when compared with its basal (p ⁇ 0.01), demonstrating synergistic effect when administered as combination (Figure 1 and Figure 2).
- Combined anti-aggressive like activity of masupirdine and donepezil or memantine was better than either alone treatment in resident-intruder task in Swiss albino mice.
- DOI induced head twitch response is considered to be a behavioral model of hallucination (Pharmacol Rep. 2012;64(6): 1567-72).
- Male Wistar rats of 200-290 g were weighed and randomized according to their body weights. On day 1, rats were first habituated to the arena for 15 min. On day 2, masupirdine was administered 1 h before trial. Donepezil was administered 30 min before the trial. 15 min before the trial, rats were subjected to habituation and immediately following the habituation, DOI, 5 mg/kg s.c was administered. The rats were then placed in the arena and head twitches were recorded for 10 min. Data were analyzed using GraphPad Prism software.
- Rats treated with DOI (5 mg/kg, s.c.) showed an increase in head twitches in comparison to the vehicle treated rats.
- Masupirdine significantly reduced the number of head twitches at a dose of 1 mg/kg, p.o.
- Masupirdine in combination with donepezil significantly reduced the number of head twitches in comparison to the standard of care (donepezil) ( Figure 3).
- Example 7 Modulation of norepinephrine and dopamine levels in cortex Experimental Procedure: Male Wistar rats (240-300 g body weight) were stereotaxically implanted with a microdialysis guide cannula in prefrontal cortex (PFC; AP: +3.2 mm, ML: -0.5 mm, DV: -1.0 mm) under isoflurane anesthesia. Co-ordinates were taken according to atlas for the rat brain (Paxinos and Watson 2004) with reference points taken from bregma and vertical from the skull. The rats were allowed to recover individually for four days in a round bottom Plexiglas bowl with free access to feed and water.
- PFC prefrontal cortex
- a pre-equilibrated microdialysis probe (4 mm dialysis membrane) was inserted into PFC through the guide cannula.
- probe was perfused with artificial cerebrospinal fluid (aCSF; NaCl 150 mmol, KC1 3.0 mmol, MgCU 0.9 mmol, CaCl2. 23 ⁇ 40 1.7 mmol, pH 6.2) at a flow rate of 1.5 pL/min and a stabilization period of 2 h was maintained.
- aCSF artificial cerebrospinal fluid
- Donepezil (1 mg/kg, s.c .) or memantine (1 mg/kg, s.c.) or vehicle was administered 30 min after administration of masupirdine.
- Dialysate samples were collected for an additional period of 4 h post treatment of masupirdine (3 mg/kg, p.o.). Dialysates were stored below -50 °C prior to analysis.
- Norepinephrine and dopamine levels in dialysates were quantified using LC-MS/MS method.
- AUC Area under the curve
- Masupirdine potentiates the effects of donepezil or memantine on cortical levels of these neurotransmitters indicating that the combination of masupirdine with donepezil or memantine may have potential in the treatment of behavioral and psychiatric disorders.
Abstract
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KR20220110518A (en) | 2022-08-08 |
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